Moore F A, Sauaia A, Moore E E, Haenel J B, Burch J M, Lezotte D C
Department of Surgery, Denver General Hospital, CO, USA.
J Trauma. 1996 Apr;40(4):501-10; discussion 510-2. doi: 10.1097/00005373-199604000-00001.
To better define the epidemiology of postinjury multiple organ failure (MOF), we prospectively evaluated 457 high-risk trauma patients who survived more than 48 hours. Overall, 70 (15%) developed MOF. In 27 (39%) patients, the occurrence was early, while in 43 (61%) patients the presentation was delayed. At presentation, early MOF had more cardiac dysfunction, while late MOF had greater hepatic failure. Indices of shock were more critical risk factors for early MOF, while advanced age was more important for late MOF. While early and late MOF had a similar high incidence of major infections, these appeared to be more important in precipitating late MOF. Finally, while mortality is similar, early MOF patients appear to succumb faster. In conclusion, postinjury MOF remains a significant challenge and appears to present in at least two patterns (i.e., early versus late). Better understanding of the relative roles of the dysfunctional inflammation and infections in early MOF versus late MOF may facilitate the development of new strategies for the prevention and treatment of morbid syndrome.
为了更好地界定创伤后多器官功能衰竭（MOF）的流行病学特征，我们对457例存活超过48小时的高危创伤患者进行了前瞻性评估。总体而言，70例（15%）发生了MOF。其中27例（39%）患者为早期发生，43例（61%）患者为延迟发生。发病时，早期MOF患者心脏功能障碍更多见，而晚期MOF患者肝功能衰竭更严重。休克指标是早期MOF更关键的危险因素，而高龄对晚期MOF更重要。虽然早期和晚期MOF主要感染的发生率相似，但这些感染在引发晚期MOF方面似乎更为重要。最后，虽然死亡率相似，但早期MOF患者似乎死亡更快。总之，创伤后MOF仍然是一个重大挑战，并且似乎至少以两种模式出现（即早期与晚期）。更好地理解功能失调性炎症和感染在早期MOF与晚期MOF中的相对作用，可能有助于制定预防和治疗该病态综合征的新策略。
